Provider Demographics
NPI:1275961401
Name:MILLER, NANCY MADELINE (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MADELINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2422
Mailing Address - Country:US
Mailing Address - Phone:330-714-6767
Mailing Address - Fax:
Practice Address - Street 1:264 S ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1354
Practice Address - Country:US
Practice Address - Phone:330-379-1856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-25
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 15002431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical